Western Society of Periodontics

Clinical Studies

Volume Number 4, 1995

The possible association between localized juvenile periodontitis and supernumerary teeth

This report involved two cases in which the patient presented with both localized juvenile periodontitis and multiple supernumerary premolars. In Case I, a 17-year-old Caucasian female presented with both LJP and supernumerary premolars. Probing depth exceeded 6 mm around both upper first permanent molars and the lower left permanent molars. Radiographs revealed extensive vertical bone loss limited to these teeth. A small supernumerary tooth comprising two premolariform tooth crowns lay between the root apices of the lower right premolars. Six years after presentation the supernumerary crowns developed a single root which caused resorption of the second premolar and necessitated surgical removal. Familial history showed one sister to have LJP; no further supernumerary teeth were noted.

In Case II, a 30-year-old female followed for LJP presented with probing depths exceeding 10 mm around the upper right first permanent molar, 8 mm around the lower left, and 9 mm around the upper right central incisor. Radiographic examination revealed a single peg-shaped supplemental premolar lying between the roots of the upper left premolars with a short but formed root. No root resorption or eruption was noted. The patient was lost to follow-up 18 months after presentation. No familial record was obtained.

It was determined that both LJP and supernumerary teeth are uncommon but have a familial incidence, and their coexistence in these and other cases raises the possibility that they may be associated in a small minority of cases. Localized juvenile periodontitis exhibits a strong familial pattern, though no clear inheritance pattern has been identified. Supernumerary teeth exhibit a familial prevalence. Supernumerary premolars have different patterns than other supernumerary teeth, and it is suggested that they arise as post-permanent teeth. Both premolar supernumeraries and LJP are known to follow a familial pattern, and it may be hypothesized that some of the responsible genes may be linked, or such association may be simply a chance association. The similarity between these two cases and the previous cases raises a possible etiological connection. Reporting of further cases, however, will be required to establish any significant hypotheses. [D.S.S.]